title: Stinging insect allergies. Assessing and managing.
abstract: BACKGROUND
  Mortality secondary to insect sting anaphylaxis, though uncommon in this country, is a genuine risk to patients with venom hypersensitivity. A number of non specific and specific preventive measures are available to minimise this risk. They include proper patient counselling regarding sting avoidance and the use of self injectable adrenaline, as well as venom specific immunotherapy.
  
  
  OBJECTIVE
  This article attempts to review the spectrum of insect sting reactions, their appropriate assessment and subsequent management. Anaphylaxis is particularly emphasised with regard to first aid treatment and subsequent prevention.
  
  
  CONCLUSIONS
  The most common causes of insect stings in Australia are bees and wasps. Insect sting reactions cover a spectrum of responses, from normal to anaphylactic. Immunotherapy is indicated in those patients who experience anaphylactic responses. The presence of venom specific IgE must be demonstrated before commencing immunotherapy. Venom sensitive patients should be educated in anaphylaxis first aid with adrenaline self injectable syringes.
authors.affiliation: Department of Allergy and Clinical Immunology, Alfred Hospital, Melbourne.
authors.forename: I
authors.initials: I
authors.lastname: Glaspole
authors.forename: J
authors.initials: J
authors.lastname: Douglass
authors.forename: D
authors.initials: D
authors.lastname: Czarny
authors.forename: R
authors.initials: R
authors.lastname: O'Hehir
mesh_terms: D000322:Adrenergic Agonists / Q000627:therapeutic use*; D000707:Anaphylaxis / Q000209:etiology* / Q000517:prevention & control*; D000818:Animals; D000862:Ant Venoms / Q000506:poisoning; D000997:Antivenins / Q000627:therapeutic use; D001180:Arthropod Venoms / Q000506:poisoning*; D001315:Australia / Q000453:epidemiology; D001514:Bee Venoms / Q000506:poisoning; D004837:Epinephrine / Q000627:therapeutic use*; D006801:Humans; D006927:Hymenoptera / Q000145:classification; D007167:Immunotherapy; D007299:Insect Bites and Stings / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D014862:Wasp Venoms / Q000506:poisoning
chemical_list: D000322:Adrenergic Agonists; D000862:Ant Venoms; D000997:Antivenins; D001180:Arthropod Venoms; D001514:Bee Venoms; D014862:Wasp Venoms; D004837:Epinephrine